Exercise that increases the heart rate for a sustained period is very beneficial for helping back problems. Aerobic exercise increases the flow of blood and nutrients to back muscles, ligaments and discs, which help healing, and can decrease the stiffness in the back and joints that lead to back pain. While many patients with back pain are able to participate in vigorous exercise like running or step aerobics, others find it easier to engage in low impact aerobic exercise, which does not jar or shock the spine.

Benefits of Low Impact Aerobic Exercise

• They have fewer episodes and less severe low back pain.
• Improved function (e.g. activities of daily life and work), whereas those patients with chronic low back pain who do not engage in low impact aerobic exercise are more likely to experience the gradual loss of functional capabilities.
• Better control weight or lose weight, decreasing the stress placed on the spine structures and joints.
• An increased production of endorphins (natural painkillers) after 30 or 40 minutes of exercise can combat pain. Endorphins are natural chemicals produced by the body to reduce pain.
• Endorphins can elevate mood and relieve symptoms of depression, a condition common in those with back pain or a back injury.
• Maintain body tone, strength and combat effects of osteoporosis.
• Remove toxins as they accumulate with normal cellular processes.

Types of low impact Aerobic Exercise

There are several types of aerobic exercise that are gentle on the back and, when done on a regular basis, highly effective in providing conditioning. However, if any exercise creates pain while performing the activity one must stop immediately. Please consult your doctor or therapist before engaging in newer exercises.

• Walking. In general, walking for exercise is very gentle on the back, and walking two to three miles three times per week is very helpful for patients. Walking also has the advantage of not requiring special equipment (except a good pair of shoes suitable for walking) and it can be done inside or outside, in almost any location, including at home on a treadmill.
• Stationary bicycling. For those patients who are more comfortable seated rather than standing, biking or stationary biking may be preferable. There are several upright and recumbent (reclining) bikes that can be purchased for home use, and many come with programs preloaded so that patients have a good variety of sessions from which to choose.
• Elliptical trainer or step machine. These machines provide a low-impact workout because the participant is using pedals suspended above the ground to move in a continuous oval motion, as opposed to continuously stepping on a hard surface. The motor on the machine facilitates a smoother step or forward glide motion, which is less jarring than walking. The benefit of these machines is that they provide an aerobic workout as well as strengthening or resistance training because the arms of most cross-training machines can be pushed and pulled, thus working the upper body, and the resistance of the pedaling motion increased to require greater muscle exertion to maintain the movement.
• Water therapy.One of the best low impact aerobic exercise to off-load the spine and weight-bearing joints. Exercise in the water provides for effective conditioning while minimizing stress on the back because the buoyancy of water counteracts the gravitational pull that can compress the spine. In the water, mobility, and stretching and strengthening exercises are less painful. Water therapy exercise is especially useful for patients in too much pain to tolerate land exercises on a mat or hard floor, or for elderly patients.

Whatever low-impact exercise is used, the exercise should be vigorous enough to increase the heart rate to the target zone (which is scaled to the age of the patient) and keep it elevated. Elevating the heart rate for at least 20 minutes is required to improve cardiovascular strength, burn excess calories, and make noticeable strides in fitness.